The association of lead exposure and motor performance mediated by cerebral white matter change
The association of lead exposure and motor performance mediated by cerebral white matter change
复制标题
DOI：
10.1016/j.neuro.2006.04.008
复制
发表时间：
2007-03-01
期刊：
影响因子：
3.4
通讯作者：
Lindgren, Karen N.
中科院分区：
文献类型：
--
作者：
Bleecker, Margit L.;Ford, D. Patrick;Lindgren, Karen N.
目的是确定铅暴露是否与大脑白色物质变化（WMC）相关，如果是，WMC是否介导铅和通过沟槽钉板（GP）测量的精神发育迟缓之间的关系。在文献中，年龄是WMC的最强预测因子，因此61名50岁及以下的铅冶炼厂工人被纳入研究人群。平均（范围）年龄为40（23-50）岁，受教育年限为9（0-13）年，就业年限为19（1-26）年，当前血铅（PbB）为29（16-42）μ g/dl，工作年限加权综合血铅（IBL）为826（65-145 1）μ g/年/dl，工龄加权平均血铅（TWA）为42（17-59）μ g/dl，骨铅（PbBn）为39（-12-90）μ g Pb/g骨矿物质。记录为高信号的T2加权MRI的大脑进行了分级。在控制年龄和脑血管危险因素后，将导联变量输入逻辑回归，试图区分正常与异常MRI。在控制协变量后，采用多元线性回归分析对铅对GP的直接影响和铅通过WMC对GP的间接影响进行建模。23%的MRI中存在WMC。WMC对铅暴露指标的Logistic回归显示，协变量后IBL、TWA和PbBn的比值比显著升高。在铅暴露变量中，IBL（β = 0.339，p < 0. 10)调整协变量后，与PbBn相比，对GP的直接影响更大（P = 0.265，p < 0. 05）。10）。在调整了先导项和协变量后，WMC解释了PbBn后对GP性能的额外影响（= 0.26 1，p < 0. 10)而IBL后（P = 0.278，p < 0.05）。通径分析表明PbBn和IBL与GP的关系部分是通过WMC介导的。(c)2006年爱思唯尔公司All rights reserved.
The goals were to determine if lead exposure is associated with cerebral white matter changes (WMC) and if so, does WMC mediate the relation between lead and psychomotor slowing as measured by Grooved Pegboard (GP). In the literature, age is the strongest predictor of WMC and therefore 61 lead smelter workers age 50 and under were included in the study population. Mean (range) age was 40 (23-50) years, years of education was 9 (0-13), duration of employment was 19 (1-26), current blood lead (PbB) was 29 (16-42) mu g/dl, working lifetime weighted integrated blood lead (IBL) was 826 (65-145 1) mu g year/dl, working lifetime weighted average blood lead (TWA) was 42 (17-59) mu g/dl, and bone lead (PbBn) was 39 (-12-90) mu g Pb/g bone mineral. WMC, recorded as hyperintensities on T2-weighted MRI of the brain were graded. Lead variables were entered in a logistic regression attempting to differentiate normal versus abnormal MRI, after controlling for age and cerebrovascular risk factors. Direct effects of lead on GP and indirect effects of lead on GP through WMC was modeled using multiple linear regression analyses after controlling for the covariates. WMC were present in 23% of MRIs. Logistic regression of WMC on lead exposure metrics demonstrated significantly elevated odds ratios for IBL, TWA, and PbBn after the covariates. Of the lead exposure variables, IBL (beta = 0.339, p < 0. 10) had a larger direct effect on GP after adjusting for the covariates than PbBn (P = 0.265, p < 0. 10). After adjusting for the lead term and covariates WMC accounted for an additional effect on GP performance after PbBn ( = 0.26 1, p < 0. 10) and after IBL (P = 0.278, p < 0.05). Path analysis demonstrated that some of the relationship of both PbBn and IBL with GP is mediated by WMC. (c) 2006 Elsevier Inc. All rights reserved.